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Early systemic assessment is essential to reduce ocular and cardiovascular complications. The case describes a 61-year-old woman with sudden painless left visual field loss; imaging confirmed superotemporal BRVO with macular edema. Anti-VEGF treatment began, but delayed systemic evaluation led to an emergency hypertensive crisis. The report highlights screening gaps and the need for coordinated ophthalmology and internal medicine care.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/branch-retinal-vein-occlusion-revealing-previously-undiagnosed-systemic-disease-open-access-case-report/458412/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/branch-retinal-vein-occlusion-revealing-previously-undiagnosed-systemic-disease-open-access-case-report/458412.png","ImageObject",300,407,{"name":92,"@type":93},"นรินทร์","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the key ophthalmic diagnosis in this case?","Question",{"text":112,"@type":113},"The patient was diagnosed with superotemporal branch retinal vein occlusion (BRVO) with macular edema, confirmed by fundoscopic and angiographic findings and supported by OCT.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the condition initially treated?",{"text":117,"@type":113},"Intravitreal anti-vascular endothelial growth factor (VEGF) therapy was initiated for the BRVO, along with a request for referral for systemic evaluation.",{"name":119,"@type":110,"acceptedAnswer":120},"What systemic event occurred after the initial ophthalmology visit?",{"text":121,"@type":113},"One week later, the patient presented to the emergency department with a severe headache and was found to have a hypertensive crisis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458412,1790908243,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336475104957,"https://ap-avatar.wpscdn.com/avatar/22000c4c6bd8a5076e1?x-image-process=image/resize,m_fixed,w_180,h_180&k=1787554080175789136","Review began 11/17/2025  \nReview ended 12/04/2025  \nPublished 12/07/2025  \n© Copyright 2025  \nValipur Kolti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98675  \nOpen Access Case Report  \nBranch Retinal Vein Occlusion Revealing Previously Undiagnosed Systemic Disease  \nDaria Valipur Kolti 1 , Jakub Juszczyk 1, Sara Omidi 1, Julia Kierner 1, Dariusz Valipur Kolti 1 1. Medicine, University Clinical Centre of the Medical University of Warsaw, Warsaw, POL Corresponding author: Daria Valipur Kolti, [dariaa1446@wp.pl](dariaa1446@wp.pl)  \nAbstract  \nBranch retinal vein occlusion (BRVO) is a common cause of vision loss and frequently reflects an underlying systemic vascular disorder. Early systemic assessment is fundamental for preventing ocular and cardiovascular complications. This report describes the clinical case of a 61-year-old woman who presented with sudden, painless visual field loss in the left eye. Fundoscopic and angiographic findings confirmed superotemporal BRVO with macular edema. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy was initiated, and referral to a primary care physician for systemic evaluation was requested. However, due to the absence of a standardized referral protocol, the patient did not undergo prompt assessment. One week after the initial ophthalmologic visit, she presented to the emergency department with a severe headache and was found to have a hypertensive crisis. This case focuses attention on how retinal vascular occlusion (RVO) can be the first manifestation of an undetected systemic hypertension. It also marks the gaps in current systemic screening protocols for RVO and the need for closer collaboration between ophthalmologists and internal medicine specialists. A comprehensive and multidisciplinary evaluation of BRVO is indispensable for uncovering systemic risk factors and guiding treatment. Timely ocular therapy combined with systemic management can prevent irreversible visual loss and systemic complications.  \nCategories: Internal Medicine, Ophthalmology  \nKeywords: anti-vegf therapy, arterial hypertension, branch retinal vein occlusion, multidisciplinary care, retinal vascular disease  \nIntroduction  \nRetinal vein occlusion (RVO) is one of the principal retinal vascular disorders, representing a significant cause of visual impairment [1] . It is estimated to affect approximately 16 million people worldwide. Among its subtypes, branch retinal vein occlusion (BRVO) occurs predominantly among all ethnic groups [2] . The arterio-venous crossing anatomy is a key element of BRVO pathogenesis. An anteriorly running arteriole compresses the underlying vein, contributing to occlusion. As a consequence, patients often notice a subtle blurring in a part of their visual field. BRVO typically presents with characteristic fundoscopic image, such as intraretinal hemorrhages, dilated and tortuous veins, cotton-wool spots, and macular edema [3] . The multifactorial nature of RVO has been reflected in a case-control study by Rath et al. (1992), which identified systemic hypertension, open-angle glaucoma, and male sex as major independent risk factors [4] . Arterial hypertension remains the strongest risk factor in both subtypes [5] . Notably, hypertension and diabetes-related end-organ damage promote vascular remodeling, atherosclerotic changes, and impaired endothelial function, all of which markedly predispose individuals to BRVO [6] . Given the multifactorial pathogenesis of this condition and its implications beyond the eye, it is crucial to emphasize the role of ophthalmologists in early diagnosis and timely referral for systemic evaluation. The present case report highlights the importance of comprehensive care in BRVO in unmasking a previously undiag","cbCaift3RzYrGxpD","https://ap.wps.com/l/cbCaift3RzYrGxpD","pdf",3597835,"English","# Abstract\n# Introduction\n# Case Presentation\n## Patient information\n## Ophthalmologic examination\n## Imaging findings","[{\"question\":\"What is the key ophthalmic diagnosis in this case?\",\"answer\":\"The patient was diagnosed with superotemporal branch retinal vein occlusion (BRVO) with macular edema, confirmed by fundoscopic and angiographic findings and supported by OCT.\"},{\"question\":\"How was the condition initially treated?\",\"answer\":\"Intravitreal anti-vascular endothelial growth factor (VEGF) therapy was initiated for the BRVO, along with a request for referral for systemic evaluation.\"},{\"question\":\"What systemic event occurred after the initial ophthalmology visit?\",\"answer\":\"One week later, the patient presented to the emergency department with a severe headache and was found to have a hypertensive crisis.\"}]","Branch Retinal Vein Occlusion Revealing Previously Undiagnosed Systemic Disease - open access case report | PDF",1790752887,15]